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Abstract

Background

Between 2020 and 2023, ECDC has supported 21 of 30 EU/EEA and six Western Balkan countries by enhancing severe acute respiratory infection (SARI) surveillance to monitor trends, detect unexpected events, evaluate public health interventions, identify risk factors and support vaccine effectiveness studies. Using diverse strategies, countries have implemented SARI surveillance and reported data at national/European levels.

Aim

We evaluated European-level SARI surveillance and provided recommendations to achieve objectives and improve key attribute performance.

Methods

We analysed 2022/23 surveillance data for completeness. We administered a questionnaire, targeting country-level representatives, to evaluate surveillance attributes (meeting objectives, usefulness, acceptability, timeliness, representativeness) and identify strengths, weaknesses, opportunities and threats.

Results

Thirteen countries (13/27) reported data at European level. Data showed good overall completeness but varied across countries and some variables need improvement (vaccination, sequencing). The questionnaire was completed by all 27 countries. Most countries (23/27) reported that the system effectively monitored trends and considered it useful and acceptable (25/27), but only 16 found it timely and 14 representative. Challenges included insufficient case-based data, data linkage issues and insufficient data completeness. Slow/inefficient manual data extraction affected timeliness, while insufficient geographical coverage affected representativeness. Multi-pathogen surveillance was identified as the main strength, heterogeneity of systems the main weakness, improvements of hospital information systems the main opportunity, and lack of sustainable funding the main threat.

Conclusions

SARI surveillance was perceived as effective in monitoring trends, useful and acceptable. To achieve additional objectives and enhance timeliness and representativeness, we recommend improving data completeness, digitalisation/automation and geographical coverage.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2025-05-22
2025-05-24
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Evaluation of European severe acute respiratory infection (SARI) surveillance, 27 European countries, 2022/23
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Diogo+FP+Marques&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marques Diogo FP</a>, <a href="/search?value1=Dory+Kovacs&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kovacs Dory</a>, <a href="/search?value1=Miguel-Angel+Sanchez-Ruiz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sanchez-Ruiz Miguel-Angel</a>, <a href="/search?value1=Ana+Paula+Rodrigues&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rodrigues Ana Paula</a>, <a href="/search?value1=Ausenda+Machado&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Machado Ausenda</a>, <a href="/search?value1=Clara+Mazagatos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mazagatos Clara</a>, <a href="/search?value1=Susana+Monge&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Monge Susana</a>, <a href="/search?value1=Lisa+Domegan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Domegan Lisa</a>, <a href="/search?value1=Joan+O%E2%80%99Donnell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">O’Donnell Joan</a>, <a href="/search?value1=Mariette+Hooiveld&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hooiveld Mariette</a>, <a href="/search?value1=Hanne-Dorthe+Emborg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Emborg Hanne-Dorthe</a>, <a href="/search?value1=Baltazar+Nunes&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nunes Baltazar</a>, <a href="/search?value1=Carlos+Carvalho&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carvalho Carlos</a>, <a href="/search?value1=Angela+MC+Rose&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rose Angela MC</a></span>. Evaluation of European severe acute respiratory infection (SARI) surveillance, 27 European countries, 2022/23. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(20):pii=2400655. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.20.2400655" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.20.2400655</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 01 Oct 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 22 Feb 2025 </span> </p>
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